Satılmış Ahmet Burak, Ülker Ahmet, Uzunay Zafer, Cengiz Tolgahan, Temiz Abdurrahim, Yaşar Mustafa, Mutlu Tansel, Daşar Uygar
Department of Orthopedics and Traumatology, Taşköprü State Hospital, Kastamonu 37400, Turkey.
Department of Orthopedics and Traumatology, Mersin University, Mersin 33110, Turkey.
Medicina (Kaunas). 2025 Jan 14;61(1):110. doi: 10.3390/medicina61010110.
The study aimed to evaluate a newly designed semicircular implant for the fixation of Vancouver Type B1 periprosthetic femoral fractures (PFFs) in total hip arthroplasty (THA) patients. To determine its strength and clinical applicability, the new implant was compared biomechanically with conventional fixation methods, such as lateral locking plate fixation and a plate combined with cerclage wires. : Fifteen synthetic femur models were used in this biomechanical study. A Vancouver Type B1 periprosthetic fracture was simulated by osteotomy 5 mm distal to the femoral stem. The models were divided into three groups: Group I (lateral locking plate fixation), Group II (lateral locking plate with cerclage wires), and Group III (new semicircular implant system). All fixation methods were subjected to axial loading, lateral bending, and torsional force testing using an MTS biomechanical testing device. Failure load and displacement were measured to assess stability. : The semicircular implant (Group III) demonstrated a significantly higher failure load (778.8 ± 74.089 N) compared to the lateral plate (Group I: 467 ± 68.165 N) and plate with cerclage wires (Group II: 652.4 ± 65.474 N; < 0.001). The new implant also exhibited superior stability under axial, lateral bending, and torsional forces. The failure load for Group III was more robust, with fractures occurring at the screw level rather than plate or screw detachment. : Compared to traditional fixation methods, the newly designed semicircular implant demonstrated superior biomechanical performance in stabilizing Vancouver Type B1 periprosthetic femoral fractures. It withstood higher physiological loads, offered better structural stability, and could be an alternative to existing fixation systems in clinical practice. Further studies, including cadaveric and in vivo trials, are recommended to confirm these results and assess the long-term clinical outcomes.
该研究旨在评估一种新设计的半圆形植入物，用于固定全髋关节置换术（THA）患者中温哥华B1型假体周围股骨骨折（PFF）。为了确定其强度和临床适用性，将这种新植入物与传统固定方法进行生物力学比较，如外侧锁定钢板固定以及钢板联合环扎钢丝固定。：本生物力学研究使用了15个合成股骨模型。在距股骨干远端5毫米处进行截骨术，模拟温哥华B1型假体周围骨折。模型分为三组：第一组（外侧锁定钢板固定）、第二组（外侧锁定钢板联合环扎钢丝）和第三组（新型半圆形植入系统）。使用MTS生物力学测试装置对所有固定方法进行轴向加载、侧向弯曲和扭转力测试。测量失效载荷和位移以评估稳定性。：与外侧钢板（第一组：467±68.165牛）和钢板联合环扎钢丝（第二组：652.4±65.474牛；<0.001）相比，半圆形植入物（第三组）的失效载荷显著更高（778.8±74.089牛）。这种新植入物在轴向、侧向弯曲和扭转力作用下也表现出更好的稳定性。第三组的失效载荷更强，骨折发生在螺钉水平而非钢板或螺钉脱离处。：与传统固定方法相比，新设计的半圆形植入物在稳定温哥华B1型假体周围股骨骨折方面表现出卓越的生物力学性能。它能承受更高的生理载荷，提供更好的结构稳定性，并且在临床实践中可能成为现有固定系统的替代方案。建议进行进一步研究，包括尸体和体内试验，以证实这些结果并评估长期临床结果。
